Upper GI & HPB Surgery Interview Questions & Answers

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Last updated 24 October 2026 · Created by a practising NHS doctor · Independent of the NHS

Quick answer

What questions are asked in an NHS Upper GI & HPB Surgery interview?

NHS Upper GI & HPB Surgery interviews usually mix values-based questions with scenarios specific to the role. Typical themes include motivation and career plans, anastomotic leak after oesophagectomy, acute pancreatitis, cholangitis and gallstone disease, emergency cholecystectomy and bile duct injury and upper GI bleeding. Every interview panel writes its own questions, so practise the themes rather than memorising answers. The 8 free questions on this page cover a spread of them.

 

At a glance

• Role: Upper GI & HPB Surgery (NHS Medical and Dental)

• Questions: 40 original practice questions, each with a full model answer

• Free to read: the first 8 questions and answers on this page

• Full bank: £4.99, 12 months of access, no subscription

• Independent: not affiliated with or endorsed by the NHS

 

Read 8 questions in full, free, and see exactly what you get before you pay. Unlock the other 32 for £4.99. One payment, 12 months of access, no subscription. Secure checkout through Stripe.

These are original practice questions written to reflect how NHS interviews are run. They are not leaked or official questions, and Healthcare Interview Prep is independent of the NHS.

 

 

Free NHS interview questions and model answers

 

 

Question 1: Why have you chosen upper GI and HPB surgery, and why do you want to join this unit?

Motivation question  ·  Motivation

 

What the interview panel is assessing

The panel wants a genuine, specific reason for choosing upper GI, hepatopancreatobiliary or bariatric surgery, and evidence that you understand what this unit does: its case mix, its role as a regional or specialist centre and its emergency workload. They are also judging whether your expectations are realistic and whether you will stay.

 

Model answer

I can trace it back to a patient I looked after as a core trainee. He was in his fifties, had come in jaundiced and itching, and within a fortnight he had gone from a CT scan to an MDT discussion to a conversation about pancreatoduodenectomy. What struck me was how many people it took to get him there: the radiologists, the endoscopists, the specialist nurse who rang him every few days, the anaesthetists who assessed his fitness, and the surgeon who explained the operation so honestly that he went into it frightened but clear about why. I wanted to be part of that kind of team.

Since then my interest has only grown. I enjoy the technical side, the anatomy of the hepatocystic triangle and the porta hepatis, and the fact that these are operations where precision really matters. But I also like the breadth. In one week on my current rotation I was involved in a hot gallbladder list, an oesophageal cancer MDT, a patient with severe pancreatitis on the high dependency unit and a bariatric clinic. Very few specialties combine major elective cancer surgery with such a busy emergency workload.

As for this unit, I looked carefully before applying. You are a regional centre for oesophago-gastric and pancreatic resection, you run a dedicated emergency gallstone pathway, and your published audit results are strong. I spoke to one of your current registrars, who told me about the structured operative training on the minimally invasive lists and the weekly morbidity and mortality meeting, which is run in a way that people actually learn from. That culture matters to me.

I am realistic about it. The on-call is demanding, the patients are often very unwell, and some outcomes are hard. But I would rather train and work somewhere with high volume, good governance and supportive seniors than somewhere quieter where I would not develop. I see myself contributing to the emergency service immediately while building my elective skills under supervision.

 

Why this answer works

This answer opens with one specific patient, shows understanding of the multidisciplinary nature of the specialty, and proves the candidate has researched the unit rather than giving a generic answer. It balances technical interest with patient care and ends with realistic expectations. Replace the patient story, rotation details and unit facts with your own, and check the unit's real services before the interview.

 

Key points to include

• A specific, personal reason rather than a general interest in surgery
• Show you understand the mix of emergency, cancer and benign work
• Evidence of research into this unit: centre status, pathways, audit results, training
• Link what the unit offers to your development and what you will give back
• Realistic expectations about workload and difficult outcomes

 

Common mistakes to avoid

• Saying you like operating with nothing about patients or teams
• An answer that would fit any surgical unit in the country
• Focusing only on what you will gain, such as index cases or training numbers
• Overclaiming experience in major resections you have only assisted with

 

NHS values and standards

Commitment to quality of care; Compassion; Working together for patients. GMC Good Medical Practice: Knowledge, skills and development.

 

Further reading

• NHS Constitution for England
• GMC Good Medical Practice
• Royal College of Surgeons of England: Good Surgical Practice
• AUGIS: The Provision of Services for Upper Gastrointestinal Surgery

 

 

Question 2: It is day five after an oesophagectomy. The nurse calls because the patient has developed new fast atrial fibrillation and a rising temperature. How would you manage this?

Clinical question  ·  Clinical knowledge

 

What the interview panel is assessing

The panel is assessing whether you recognise new arrhythmia and fever after oesophagectomy as a possible anastomotic leak or conduit problem until proven otherwise, whether you use a structured ABCDE approach, investigate appropriately, escalate early and work with critical care, rather than simply treating the rhythm.

 

Model answer

My first thought would be that new atrial fibrillation and fever at this stage after an oesophagectomy is an anastomotic leak, conduit ischaemia or a chest complication until I have shown otherwise. Arrhythmia is often the first sign, so I would not treat it as an isolated cardiology problem.

I would go and see the patient straight away and assess them with ABCDE. I would look at their NEWS2 trend, oxygen requirement, work of breathing, blood pressure, perfusion and urine output. I would check the chest drains and the neck wound if there is one, looking at the volume and character of the fluid, any change to a cloudy, bilious or feculent appearance, and any surgical emphysema. I would make sure the patient remains nil by mouth and the feeding plan is reviewed, and I would ask the nurse whether anything has been given orally.

At the same time I would send bloods including a full blood count, inflammatory markers, renal function, electrolytes including magnesium and potassium, lactate and cultures, and do an ECG. If the patient met sepsis criteria I would start the trust's sepsis pathway with antibiotics and antifungal cover as per local protocol. For the rhythm, I would correct electrolytes and discuss rate or rhythm control with the critical care or medical team rather than acting alone, especially if the patient was haemodynamically compromised.

The key investigation is usually a CT of the chest and abdomen with oral and intravenous contrast, and depending on the unit's practice, an early endoscopy by an experienced upper GI surgeon to look directly at the anastomosis and conduit viability. I would discuss this with the consultant on call early rather than waiting for the scan result.

I would escalate to critical care if there was any sign of organ dysfunction. Management of a confirmed leak depends on its size, the state of the conduit and how unwell the patient is, ranging from drainage and endoscopic therapy to return to theatre, and that is a consultant-led decision. Throughout, I would keep the patient and family informed and document clearly.

 

Why this answer works

This answer works because it names the dangerous diagnosis first, shows a calm structured assessment, and covers drains, nil by mouth, sepsis, electrolytes and imaging without inventing doses or thresholds. It escalates to the consultant and critical care early. Adapt it to a post-operative patient you have actually managed, and describe your own unit's leak protocol if you know it.

 

Key points to include

• Treat new AF after oesophagectomy as a possible leak until proven otherwise
• ABCDE assessment, NEWS2 trend and examination of drains and wounds
• Sepsis pathway, cultures, electrolytes and an ECG
• Early contrast CT and consideration of endoscopy per unit practice
• Early consultant and critical care involvement; consultant-led definitive plan
• Keep the patient and family informed and document

 

Common mistakes to avoid

• Treating the arrhythmia alone and missing the leak
• Forgetting to check drains or keep the patient nil by mouth
• Quoting specific drug doses instead of following local protocol
• Waiting for morning ward round before escalating

 

NHS values and standards

Commitment to quality of care; Working together for patients; Compassion. GMC Good Medical Practice: Colleagues, culture and safety.

 

Further reading

• NICE guideline NG83: Oesophago-gastric cancer: assessment and management in adults
• NICE guideline NG51: Suspected sepsis: recognition, diagnosis and early management
• Royal College of Physicians: National Early Warning Score (NEWS) 2
• AUGIS: The Provision of Services for Upper Gastrointestinal Surgery

 

 

Question 3: A district general hospital refers a patient with severe acute pancreatitis who is deteriorating on their ward. How would you handle the referral and advise on management?

Clinical question  ·  Clinical knowledge

 

What the interview panel is assessing

The panel wants to see that you understand current principles of acute pancreatitis care, including supportive management, the role of critical care, nutrition, imaging timing and the indications for intervention, and that you can manage a tertiary referral safely: clear advice, documentation, transfer decisions and consultant involvement.

 

Model answer

I would start by taking a structured referral, ideally using SBAR, and making a written record on the unit's referral system. I would want to know the cause if known, the timing of onset, the patient's observations and NEWS2 trend, their organ function, fluid balance and urine output, oxygen requirement, the blood results, any imaging so far, and their comorbidities and frailty. I would also ask whether critical care at their hospital has reviewed the patient.

Most of the early management is supportive, and much of it can happen at the referring hospital. My advice would be guided fluid resuscitation with careful reassessment to avoid both under and over filling, oxygen as needed, analgesia, close monitoring, and early involvement of their critical care team if there are signs of persistent organ failure. I would advise early enteral nutrition rather than prolonged starvation, in line with NICE guidance, and that prophylactic antibiotics are not routinely indicated, while any proven infection should be treated. If gallstones are the cause and there is cholangitis or persistent biliary obstruction, urgent ERCP should be considered.

I would ask whether they have arranged cross-sectional imaging. Early CT is useful if the diagnosis is uncertain, but for assessing necrosis, contrast CT is more informative after the first few days. I would ask them to share images through the image transfer system so our radiologists and consultant can review them.

Transfer depends on whether the patient needs something only a specialist centre can provide, such as interventional radiology, endoscopic or surgical necrosectomy, or management of complications like infected necrosis or bleeding. A deteriorating patient needs a critical care bed, and moving an unstable patient can be risky, so that decision would be made with my consultant and both critical care teams.

I would document the advice given, agree a time to speak again, and make sure the referring team knows how to reach us urgently. Pancreatitis can change quickly, so follow up matters as much as the first call.

 

Why this answer works

The answer covers what a specialist registrar or fellow genuinely does: a structured referral, principle-level supportive management consistent with NICE NG104, sensible imaging timing, and a transfer decision shared with the consultant and critical care. It avoids doses and specific scoring cut-offs. Use a referral you have personally handled and mention your own network's arrangements.

 

Key points to include

• Structured SBAR referral, documented on the unit's system
• Supportive care: fluids with reassessment, oxygen, analgesia, early enteral nutrition
• No routine prophylactic antibiotics; ERCP for cholangitis or persistent obstruction
• Imaging timing and image transfer for specialist review
• Transfer decision involving consultant and critical care at both sites
• Agree follow-up and document advice

 

Common mistakes to avoid

• Accepting every patient for transfer regardless of stability or need
• Advising routine prophylactic antibiotics
• Giving advice without documenting it or arranging follow-up
• Forgetting the gallstone and cholangitis pathway

 

NHS values and standards

Working together for patients; Commitment to quality of care; Everyone counts. GMC Good Medical Practice: Colleagues, culture and safety.

 

Further reading

• NICE guideline NG104: Pancreatitis
• NICE guideline CG188: Gallstone disease: diagnosis and management
• NHS England: Patient Safety Incident Response Framework
• Royal College of Surgeons of England: Good Surgical Practice

 

 

Question 4: What does patient-centred care mean to you when treating patients with upper GI or pancreatic cancer?

Values question  ·  Values

 

What the interview panel is assessing

The panel is checking that you see the person behind the diagnosis: that you share decisions honestly, respect what matters to the patient, involve the specialist nurse and palliative teams, and understand that many patients with these cancers will not be cured. They want real behaviours, not slogans.

 

Model answer

For me it starts with recognising that most patients with oesophageal, gastric or pancreatic cancer will face very difficult choices, and that a large proportion will not be suitable for curative treatment. So patient-centred care means making sure the decision is shaped by what matters to them, not only by what is technically possible.

I think of a woman I met in clinic who had a locally advanced gastric cancer. The MDT had recommended chemotherapy followed by surgery. When I asked her what was most important to her, she said she wanted to be well enough for her daughter's wedding in four months. That changed the conversation. We talked honestly about what neoadjuvant treatment and a gastrectomy would involve, the recovery time and the effect on eating, and we involved the oncologist so she understood the timing. She still chose treatment, but she did it with a clear plan around the wedding, and the clinical nurse specialist helped her with that.

In practice, patient-centred care means a few concrete things. I explain options in plain language, including the option of not having an operation, and I check understanding rather than assuming it. I make sure the clinical nurse specialist is in the room or contacted afterwards, because they are often the person the patient rings. I think about nutrition, prehabilitation and dietetic input early, because these patients are often losing weight. And when cure is not possible, I involve palliative care early rather than as a last step, and focus on symptom control, such as stenting for dysphagia or biliary drainage for jaundice.

It also means respecting dignity on the ward after major surgery: explaining why someone is nil by mouth, why they have a jejunostomy, and listening when they are frightened. These operations take a lot from people, and they deserve to understand and agree with every step.

 

Why this answer works

This answer brings values to life with a specific clinic conversation and then lists concrete behaviours: shared decisions, honest discussion of no surgery, specialist nurse involvement, nutrition and early palliative care. It reflects GMC guidance on decision making and consent. Swap in your own patient and focus on what you personally did.

 

Key points to include

• Ask what matters to the patient and let it shape the plan
• Present all options honestly, including no operation
• Involve the clinical nurse specialist, dietitian and oncology team
• Early palliative care and symptom-focused interventions when cure is not possible
• Dignity and explanation during the post-operative recovery

 

Common mistakes to avoid

• Describing patient-centred care in abstract terms with no example
• Implying surgery is always the best outcome
• Leaving out the wider team, especially specialist nurses
• Treating palliative care as failure rather than good care

 

NHS values and standards

Compassion; Respect and dignity; Improving lives. GMC Good Medical Practice: Patients, partnership and communication.

 

Further reading

• GMC: Decision making and consent
• NICE guideline NG83: Oesophago-gastric cancer: assessment and management in adults
• NICE guideline NG85: Pancreatic cancer in adults: diagnosis and management
• NHS Constitution for England

Found these useful? The other 32 questions cover the rest of the role, each with a full model answer. Unlock all 40 for £4.99.

 

 

Question 5: Tell us about a time you disagreed with a colleague about a patient's management. How did you resolve it?

Competency question  ·  Teamwork

 

What the interview panel is assessing

The panel is assessing how you handle professional disagreement: whether you stay focused on the patient, listen to the other view, use evidence and escalation appropriately, and maintain working relationships. They want a STAR example with a clear outcome and reflection, not a story where you were simply right.

 

Model answer

As a registrar on a busy general surgical on-call, I was asked to review a man in his seventies on a medical ward with right upper quadrant pain, fever and deranged liver tests. He had been admitted with a chest infection. My impression was acute cholangitis secondary to gallstones, and I felt he needed urgent biliary drainage. The medical registrar felt that his chest was the main source and wanted to continue antibiotics and reassess the next day.

My task was to make sure the patient received the right treatment without turning it into a contest between teams. I asked if we could look at the patient and results together. We went through his ultrasound, which showed a dilated common bile duct with stones, and his trend of bilirubin and inflammatory markers. I acknowledged that his chest findings were real and that both problems could coexist. I explained why I was worried: he was becoming more confused and his blood pressure was softening, and cholangitis can deteriorate quickly without drainage.

We agreed on a shared plan. He would stay on antibiotics covering both sources, we would escalate his care level, and I would discuss urgent ERCP with the on-call gastroenterologist and my consultant. My consultant supported this, and the gastroenterology team performed ERCP the following morning, finding and clearing pus and stones from the duct. He improved significantly over the next two days and was later listed for cholecystectomy.

Looking back, what helped was keeping the conversation about the patient's data and being willing to say that the other team had a point. I also learned to involve my consultant earlier when two teams have different views, because that removes delay. The medical registrar and I worked well together for the rest of the rotation, and we later agreed a simple joint review process for jaundiced patients on medical wards.

 

Why this answer works

This STAR answer shows clinical reasoning, respect for the other team, escalation to the consultant and a clear patient outcome, plus a learning point and a small improvement afterwards. It avoids blaming anyone. Replace it with a real disagreement from your own practice, ideally one where you also learned something from the other person.

 

Key points to include

• Use a clear STAR structure with a real patient outcome
• Show respect for the other clinician's view
• Use shared review of data and evidence
• Escalate to consultants when views differ and delay risks harm
• Reflect on what you learned and any improvement made

 

Common mistakes to avoid

• Choosing an example where you simply proved someone wrong
• Criticising colleagues or other specialties
• Describing an argument in front of the patient or family
• Having no outcome or reflection

 

NHS values and standards

Working together for patients; Respect and dignity; Commitment to quality of care. GMC Good Medical Practice: Colleagues, culture and safety.

 

Further reading

• GMC Good Medical Practice
• Royal College of Surgeons of England: Good Surgical Practice
• GMC: Leadership and management for all doctors

 

 

Question 6: You become concerned that a senior surgical colleague's complication rates and behaviour in theatre may be putting patients at risk. What would you do?

Scenario question  ·  Raising concerns

 

What the interview panel is assessing

The panel wants to know that you understand your professional duty to act on concerns about a colleague, that you gather facts fairly, use the right channels in order, protect patients first, and treat the colleague with respect and support. They will expect knowledge of GMC guidance and Freedom to Speak Up routes.

 

Model answer

This is one of the hardest situations in surgery, but my duty under Good Medical Practice is clear: patient safety comes first, and I must act if I believe patients are at risk, even when the person is senior to me.

First, I would be careful to separate facts from impressions. I would ask myself what exactly I have seen. For example, repeated returns to theatre after a particular procedure, unusual delays in recognising complications, or behaviour in theatre such as shouting at staff so that people are afraid to speak up. I would look at objective information I legitimately have access to, such as the unit's morbidity and mortality data or audit results, without starting my own investigation into the person.

If there were an immediate risk, for example a colleague who appeared impaired before an operation, I would act straight away to stop the procedure safely and inform the clinical director or most senior person available. If the concern were about a pattern, I would usually raise it first with my educational or clinical supervisor or the consultant I trust most, explain what I had observed and ask for advice. The next step would be the clinical lead or clinical director, and the unit's governance process, including incident reporting through the trust system where specific events have caused harm.

If I felt my concerns were not being taken seriously, I would use the trust's Freedom to Speak Up Guardian and, if necessary, the medical director. As a last resort, there are external routes, including the GMC. I would keep a factual, dated record of what I raised and with whom.

Throughout, I would remember that the colleague may be struggling, for example with burnout or health problems, and that the aim is safe care and support, not punishment. Behaviour that stops theatre staff raising concerns is itself a safety issue, because it undermines the checklist and the whole culture of speaking up.

 

Why this answer works

The answer shows a mature, staged approach: facts first, immediate action for immediate danger, then supervisors, clinical director, governance and Freedom to Speak Up, with external routes as a last resort. It is fair to the colleague and links behaviour to safety culture. Use your own trust's channels and, if appropriate, a real but anonymised example of raising a concern.

 

Key points to include

• Patient safety comes first, regardless of seniority
• Separate observed facts from impressions; do not run your own investigation
• Immediate action if there is immediate risk
• Escalate in steps: supervisor, clinical lead, clinical director, Freedom to Speak Up, medical director
• Keep a factual record and consider the colleague's wellbeing
• Recognise that intimidating behaviour is a patient safety issue

 

Common mistakes to avoid

• Saying you would do nothing because the colleague is senior
• Going straight to social media, the press or external bodies
• Gossiping with colleagues instead of using formal routes
• Collecting data on the person in a way that breaches confidentiality

 

NHS values and standards

Commitment to quality of care; Respect and dignity; Everyone counts. GMC Good Medical Practice: Colleagues, culture and safety.

 

Further reading

• GMC: Raising and acting on concerns about patient safety
• GMC Good Medical Practice
• National Guardian's Office: Freedom to Speak Up guidance
• Royal College of Surgeons of England: Good Surgical Practice

 

 

Question 7: A patient on the emergency take has acute calculous cholecystitis. How would you decide on the timing of surgery, and how do you keep a difficult laparoscopic cholecystectomy safe?

Clinical question  ·  Clinical knowledge

 

What the interview panel is assessing

The panel is assessing your knowledge of the index admission or hot gallbladder approach, patient selection, and safe operative principles: the critical view of safety, recognising a difficult gallbladder early, calling for help and using bail-out strategies such as subtotal cholecystectomy rather than risking bile duct injury.

 

Model answer

For most fit patients with acute cholecystitis, the evidence and NICE guidance support offering laparoscopic cholecystectomy during the index admission or soon after diagnosis, rather than sending them home to wait. Early surgery reduces readmissions with further gallstone complications and overall length of stay. In my last unit we had a dedicated emergency gallstone list, which made this realistic.

Whether to operate early depends on the patient. I would think about their fitness and frailty, how long the symptoms have been present, whether there is a suspected common bile duct stone or cholangitis needing imaging or ERCP first, and their wishes. For a very unwell or frail patient, antibiotics with or without percutaneous cholecystostomy may be safer initially, with an interval decision later.

In theatre, my priority is avoiding bile duct injury. I always aim to achieve the critical view of safety before clipping or dividing anything: clearing the hepatocystic triangle so only two structures enter the gallbladder, and separating the lower part of the gallbladder from the liver bed. I call a time out with the team to confirm the view. If the anatomy is unclear because of inflammation or fibrosis, I stop and reassess rather than pushing on.

I have a low threshold for asking a consultant or a second experienced surgeon to scrub in, and I am comfortable saying so. Bail-out options include a subtotal cholecystectomy, either fenestrating or reconstituting, a fundus-first approach if appropriate, or placing a drain and abandoning the operation. Intraoperative cholangiography can help clarify anatomy. Converting to open is not automatically safer if the open surgeon is less experienced, so I see it as one option, not the default.

Afterwards I document the operative findings clearly, including whether the critical view was achieved, and explain to the patient what was done and what to look out for, especially if a subtotal approach makes a bile leak more likely.

 

Why this answer works

This answer combines evidence-based timing with patient selection, then gives a clear, safe operative philosophy: critical view of safety, time out, early help and recognised bail-out options. It sounds like a surgeon who knows their limits. Replace the details with your own gallstone pathway experience and your actual operative logbook numbers if asked.

 

Key points to include

• Offer early laparoscopic cholecystectomy for suitable patients, in line with NICE CG188
• Assess frailty, duration, possible duct stones and patient wishes
• Achieve and confirm the critical view of safety before dividing structures
• Stop, reassess and call for help when anatomy is unclear
• Know bail-out strategies, including subtotal cholecystectomy
• Document findings and counsel the patient afterwards

 

Common mistakes to avoid

• Saying all patients should wait several weeks for interval surgery
• Not mentioning the critical view of safety
• Presenting conversion to open as always the safest option
• Implying you would carry on alone in a hostile field

 

NHS values and standards

Commitment to quality of care; Improving lives; Working together for patients. GMC Good Medical Practice: Knowledge, skills and development.

 

Further reading

• NICE guideline CG188: Gallstone disease: diagnosis and management
• AUGIS and Royal College of Surgeons of England: Commissioning guide for gallstone disease
• Tokyo Guidelines 2018 for acute cholecystitis
• WHO Surgical Safety Checklist

 

 

Question 8: You are the surgical registrar on call. A patient with a large upper GI bleed is still bleeding after endoscopic treatment. What would you do?

Clinical question  ·  Clinical knowledge

 

What the interview panel is assessing

The panel wants to see that you can manage a life-threatening upper GI bleed as part of a team: resuscitation using a major haemorrhage protocol, close work with endoscopy, interventional radiology and critical care, timely consultant involvement and a clear understanding of when surgery is appropriate.

 

Model answer

This patient is in danger, so my first priority would be resuscitation, working with the anaesthetic and critical care teams. I would assess with ABCDE, ensure large-bore access, and activate the trust's major haemorrhage protocol if they were unstable or bleeding heavily, so that blood products arrive quickly and in a balanced way. I would check the coagulation results and whether they take anticoagulant or antiplatelet medicines, and ask the haematology team for advice on reversal as per local policy. Airway protection may be needed if there is ongoing haematemesis or reduced consciousness.

Next I would speak directly to the endoscopist to understand exactly what they saw: the source, for example a posterior duodenal ulcer, whether there was a visible vessel, what treatment was given and whether they think a second endoscopic attempt is worthwhile. NICE guidance supports repeat endoscopy in selected patients and interventional radiology for those who rebleed after endoscopic treatment, particularly if they are unstable.

I would contact the on-call interventional radiologist early, because embolisation is often the next step for a bleeding duodenal ulcer and avoids a high-risk operation in an elderly or comorbid patient. If a CT angiogram can be done safely, it helps localise the bleeding. At the same time I would inform my consultant, because if radiology is unavailable or unsuccessful, surgery may be needed, and that decision and operation should involve a consultant.

While this is happening I would make sure the patient has been started on acid suppression after endoscopy in line with guidance, is catheterised for urine output monitoring, and that a critical care bed is requested. I would keep the patient and family informed, including an honest discussion about the risks of each option, and consider any advance decisions or ceilings of care.

I would document the timeline clearly, as these situations move fast. Afterwards, I would want the case discussed at the morbidity and mortality meeting to review whether the pathway worked.

 

Why this answer works

This answer prioritises resuscitation, then coordinates endoscopy, interventional radiology, critical care and the consultant in the order NICE CG141 supports. It avoids doses and numerical targets while showing command of the pathway. Use your own experience of an upper GI bleed and refer to your trust's major haemorrhage protocol by name if you can.

 

Key points to include

• Resuscitate first: ABCDE, access, major haemorrhage protocol
• Address anticoagulants and coagulopathy with haematology advice
• Speak directly to the endoscopist about findings and options
• Early interventional radiology and CT angiography where safe
• Consultant involvement for any surgical decision; critical care bed
• Communicate with the family and document the timeline

 

Common mistakes to avoid

• Going straight to surgery without considering interventional radiology
• Forgetting the major haemorrhage protocol or anticoagulant reversal
• Quoting transfusion triggers or drug doses as fixed numbers
• Managing alone without informing the consultant

 

NHS values and standards

Commitment to quality of care; Working together for patients; Compassion. GMC Good Medical Practice: Colleagues, culture and safety.

 

Further reading

• NICE guideline CG141: Acute upper gastrointestinal bleeding in over 16s: management
• National Confidential Enquiry into Patient Outcome and Death: Time to Get Control?
• Royal College of Surgeons of England: Good Surgical Practice

 

 

Ready for the other 32?

You have seen how the model answers work. Unlock the full Upper GI & HPB Surgery bank to practise every theme the panel might ask about, with the mistakes to avoid spelled out for each one.

 

 

 

About this NHS interview question bank

To prepare for an upper GI and HPB surgery interview in the NHS, practise talking through real situations out loud: a suspected anastomotic leak after oesophagectomy, severe acute pancreatitis referrals, cholangitis, a bleed after pancreatoduodenectomy, a difficult emergency cholecystectomy, an upper GI bleed and the post-bariatric patient with abdominal pain. Panels will also explore MDT working, consent, the Duty of Candour, raising concerns, published outcomes, teaching in theatre and your career plan, so prepare honest examples that show safe judgement, early escalation and compassion under pressure.

This bank is for doctors applying for upper gastrointestinal, hepatopancreatobiliary and bariatric surgery posts in the NHS, including specialty registrars at ST3 and above, specialty doctors, clinical and post-CCT fellows and consultant applicants. Each of the 40 original practice questions includes a first-person model answer, what the panel is assessing, key points, common mistakes, the NHS values it reflects and further reading from sources such as GMC Good Medical Practice, Royal College of Surgeons guidance, AUGIS and NICE. Themes cover emergency gallstone disease, pancreatitis, oesophago-gastric and pancreatic cancer pathways, post-operative complications, bariatric emergencies, consent, candour, governance, teaching and leadership.

 

What this question bank covers

• Motivation and career plans
• Anastomotic leak after oesophagectomy
• Acute pancreatitis
• Cholangitis and gallstone disease
• Emergency cholecystectomy and bile duct injury
• Upper GI bleeding
• Pancreatic cancer pathway
• Oesophago-gastric cancer MDT
• Post-pancreatectomy haemorrhage
• Bariatric emergencies
• Colorectal liver metastases
• High-risk emergency surgery and frailty
• Consent and shared decision making
• Duty of candour
• Raising concerns
• Theatre safety culture and human factors
• Outcomes, audit and revalidation
• Teaching, supervision and wellbeing

 

 

Upper GI & HPB Surgery NHS interview: frequently asked questions

 

What questions are asked in an NHS Upper GI & HPB Surgery interview?

NHS Upper GI & HPB Surgery interviews usually mix values-based questions with scenarios specific to the role. Typical themes include motivation and career plans, anastomotic leak after oesophagectomy, acute pancreatitis, cholangitis and gallstone disease, emergency cholecystectomy and bile duct injury and upper GI bleeding. Every interview panel writes its own questions, so practise the themes rather than memorising answers. The 8 free questions on this page cover a spread of them.

 

What band is an NHS Upper GI & HPB Surgery job?

The questions on this page are pitched mainly at ST3+ to Consultant, including Specialty Doctor and Clinical Fellow posts. The band for any job depends on the trust and the responsibilities of the post, so always check the advert and job description. Higher bands bring more questions on leadership, supervising others and improving the service.

 

How should I prepare for an NHS Upper GI & HPB Surgery interview?

Read the job description and person specification closely, then prepare five or six real examples you can tell using the STAR method (situation, task, action, result). Revise GMC Good Medical Practice (or the GDC Standards for dental roles), consent and capacity, safeguarding, the duty of candour and patient safety. Research the trust's own values and the service you would join, and practise your answers out loud before the day.

 

Which NHS values and standards should I mention in a Upper GI & HPB Surgery interview?

Link your examples to the NHS values from the NHS Constitution, such as compassion, respect and dignity, and working together for patients. For this role, panels will also expect you to understand GMC Good Medical Practice (or the GDC Standards for dental roles), consent and capacity, safeguarding, the duty of candour and patient safety. Show these through what you actually did rather than reciting lists.

 

Are these real NHS Upper GI & HPB Surgery interview questions?

No. They are original practice questions written to reflect how NHS Upper GI & HPB Surgery interviews are typically run. Healthcare Interview Prep is independent and not affiliated with the NHS, and nobody can promise which questions you will be asked. Use the model answers to learn structure and content, then build answers from your own experience.

 

What do I get if I unlock the full Upper GI & HPB Surgery question bank?

You get all 40 Upper GI & HPB Surgery practice questions. Each one has what the panel is assessing, a model answer, why the answer works, key points to include, common mistakes and the NHS values it links to. It is a one-off payment of £4.99 for 12 months' access, with no subscription.

Read the full NHS Medical and Dental interview guide →